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Excessive QT prolongation can trigger tachycardias such as torsades de pointes (TdP). QT prolongation is an established side effect of antiarrhythmics, but can also be caused by a wide range of non-cardiac medicines, including antibiotics, antidepressants, antihistamines, opioids, and complementary medicines.
Fluoroquinolones prolong the heart's QT interval by blocking voltage-gated potassium channels. [43] Prolongation of the QT interval can lead to torsades de pointes , a life-threatening arrhythmia , but in practice, this appears relatively uncommon in part because the most widely prescribed fluoroquinolones (ciprofloxacin and levofloxacin) only ...
Other drugs which prolong the QT interval include some antipsychotics such as haloperidol and ziprasidone, and the antidepressant citalopram. [31] [19] Lists of medications associated with prolongation of the QT interval such as the CredibleMeds database can be found online. [32]
Coadministration of moxifloxacin with other drugs that also prolong the QT interval or induce bradycardia (e.g., beta-blockers, amiodarone) should be avoided. Careful consideration should be given in the use of moxifloxacin in patients with cardiovascular disease, including those with conduction abnormalities. [39]
Fluconazole therapy has been associated with QT interval prolongation, which may lead to serious cardiac arrhythmias. Thus, it is used with caution in patients with risk factors for prolonged QT interval, such as electrolyte imbalance or use of other drugs that may prolong the QT interval (particularly cisapride and pimozide). [24]
Hence, erythromycin should not be administered to people using these drugs, or drugs that also prolong the QT interval. Other examples include terfenadine (Seldane, Seldane-D), [26] astemizole (Hismanal), [27] cisapride [28] (Propulsid, withdrawn in many countries for prolonging the QT time) and pimozide (Orap). [29]
AZCERT developed the Adverse Drug Event Causality Analysis (ADECA) to evaluate drugs for their risk of causing QT prolongation and TdP. [11] As part of its ADECA reviews, AZCERT includes drugs marketed outside the United States, especially in Europe, Japan, and Canada. In addition to their use to inform healthcare decision-making, CredibleMeds ...
Prolonged cardiac QT interval (especially erythromycin) Hearing loss (especially at higher doses) Jaundice; Inhibition of bacterial protein biosynthesis by binding reversibly to the subunit 50S of the bacterial ribosome, thereby inhibiting translocation of peptidyl tRNA. Clarithromycin: Biaxin: Erythromycin: Erythocin, Erythroped: Roxithromycin ...